A family that eats together and holds a health insurance plan together - stays healthy, happy, & financially stable together.

If this wasn’t the saying before, it is so now!

The world endured an entire pandemic together as a whole. The psychological impact, frequent health scares, & resultant financial chasm did what the IRDAI (Insurance Regulatory and Development Authority of India) had been attempting for since long. It brought in increased health insurance awareness among the common masses. Availing health insurance plans for family became a necessity.

While securing oneself against any financial crisis during a medical emergency is commendable, taking responsibility for the same for your family is an added relief.  However, before you purchase a family health insurance plan, you must know the heart and soul of the coverage. This will help you make a sound financial decision as per which your family will be covered during medical emergencies.

What is Health Insurance Plan for Families?

Health insurance plans for families are significant funding offered under an insurance policy that caters to the medical requirements of an entire family. The number of family members that can be included in the policy is largely depended on the chosen insurance provider and the availed health insurance plan.

The acceptable combination of policyholders for most health insurance providers is as follows -

  1. Policyholder + Spouse + Children under 25 years old
  2. Policyholder + Spouse

Apart from the affordability perk that the best family health insurance plans in India offer, there are other benefits too. We will be mentioning them below. Unfortunately, the plan has a few drawbacks too, without acknowledging which purchasing this policy wouldn’t be a wise financial decision. Read on!

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What are the advantages and disadvantages of Health Insurance Plans for Families?

Pros of Health Insurance Plans for Families

  • Relatively affordable premium

Compared to purchasing a health insurance plan for each member of your family and the subsequent total premium to be paid, the premium for a mediclaim policy for family is significantly less. This mitigates your financial burden to a large extent.

  • Increased bandwidth on tax benefits

Similar to a standard health insurance plan that offers coverage to a single individual, the family medical insurance plan also offers tax benefits under Section 80D. However, in the case of the family floater health insurance plan, the tax benefits offered are as per the eldest member of the policy.

So, say, if the oldest member in your family health insurance plan is a senior citizen, there is an automatic increase in the tax benefit threshold amount, which rises from INR 25,000 to INR 50,000.

  • Inclusion of children below 18

Health insurance plans for individuals younger than 18 years of age are sparse in the insurance industry. While some maternity health insurance plans offer coverage to newborns, they come with a short-lived term span, leaving the individual vulnerable to financial pitfalls in the case of any medical emergencies.

However, with the health insurance plans in India for families, such financial vulnerabilities are now out of the equation for those under 18. They can be included as dependents in the policy until they are 18 years old (some insurers allow dependents up to the age of 25), after which they can avail of the Individual Health Insurance Policy.

  • Conveniently available with all health insurers

All health insurance providers across the industry in India offer family health insurance plans. With a majority of the reputed health insurance providers, all of their plans carry the family floater option.

Cons of Health Insurance Plans for Families

  • The eldest member under the plan often determines the premium of your health insurance policy for family. So, even if you have one member in their senior year, the chances are high that you will see a spike in your premium.
  • The coverage offered under a mediclaim for family plan isn’t adequate for all the family members. If you have a member of the family who has a chronic ailment, cancer, or any other critical illness that requires frequent hospitalization, it’s best not to include him/her under this policy coverage. You can always avail of an individual plan in this case. Otherwise, the other members under the policy will be left financially unprotected despite having coverage.
  • You can’t afford to skip a single premium because your entire family loses coverage.
  • With the best health insurance plans, there is a restriction on who you can and can’t include as dependents in your policy. Under no circumstances can you include your siblings, in-laws, or parents (if you are above 18/25/or 30 - it depends on the insurer).

Should you avail of a family health insurance policy or an individual health insurance plan?

Both family health insurance policies and individual health insurance plans come with their set of perks. So, we can take up a few cases to determine which kind of health insurance policy would suit them the best -

CASE I: If you have a very high sum insured on your family health policy: The coverage is adequate for the members of the family. So family health insurance plan would be enough.
CASE II: If you have a member in the policy who has suddenly been diagnosed with a chronic ailment: Purchase an individual health insurance plan for the family member if he/she is above 18 years of age. If he /she is younger, take out an individual plan for the member of the plan who is the youngest (low premiums) with no pre-existing ailments (no loading charges).
CASE III: If you are looking for pocket-friendly health insurance coverage: Say the members of the family are 40, 45, and 18 years old.
The coverage you are looking at is INR 15 lakhs each. The premiums come to an estimated INR 16.5k, INR 17.5k, and INR 14.5k. So the total is about INR 48.5k.
On the other hand, for a family floater health insurance involving the same members for coverage of INR 15 lakhs, the premium is INR 31k.

How to determine the best Health Insurance Plans for Families?

Before you finalize your mediclaim policy for family, check these factors out among the top 5 plans of your choice -

  1. The maximum number of members allowed
  2. Minimum waiting period
  3. No copayment
  4. Restoration benefits
  5. No room rent restrictions
  6. No disease-wise limits
  7. Maximum No-Claim Bonus
  8. AYUSH treatment coverage
  9. Extensive Pre and Post-Hospitalization Coverage
  10. Daycare coverage
  11. Domiciliary coverage

Claim on the links to know more about how and why these factors are crucial while determining the best mediclaim policy for family.

Best Health Insurance Plans for Families

Best Health Insurance Plans for Families Sum Insured AYUSH Treatment Domiciliary Treatment Maternity Cover Pre and Post-Hospitalization Expenses Day Care Coverage Maximum No. Of Members Covered
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HDFC Ergo Optima Restore INR 5 lakhs - INR 50 lakhs Up to the sum insured 60 days
(Up to the sum insured)
180 days
(Up to the sum insured)
4 kids (under the age of 25) and spouse.
Niva Bupa Reassure INR 3 lakhs - INR 1 crore Up to the sum insured Up to the sum insured 30 days
(Up to the sum insured)
60 days
(Up to the sum insured)
4 kids (under the age of 30) and spouse.
Care - Care Plus INR 3 lakhs - INR 25 lakhs
(10% of the Sum Insured)
Up to the sum insured ✅(in the case of Care Plus Youth) 60
(Up to the sum insured)
90
(Up to the sum insured)
4 kids (under the age of 25) and spouse.

You can compare plans with our compare health insurance plan tool.